This Phase II SBIR grant will complete the development and evaluation of Healthcare Disparities: Patients &Providers, an e-learning course for physicians and physicians in training. The Phase I module, Healthcare Disparities, provides instruction in the evidence and causes of disparities and examines the changing meaning of race in healthcare. In Phase II, the Race IAT (Implicit Associations Test) followed by a debriefing will be incorporated in a second module on unconscious biases. The third module of the course will provide data on racial/ethnic perspectives on healthcare and will include instruction in skills for improving dimensions of the patient-provider relationship that have been linked to healthcare disparities. Version 2 of the Healthcare Disparities Knowledge Test and a Virtual Patient Assessment will be developed for use in the outcome evaluation and will be included in the final product. The goals of the completed course are to increase self awareness of racial attitudes, improve knowledge of racial/ethnic disparities, and enhance skills for patient-provider communication in order to eliminate healthcare disparities that are attributable to the patient-provider relationship. The completed e-learning course will be evaluated in an online study with resident physicians using a four group, pre-post randomized design with multiple measures. Study measures will include demographic information, the revised knowledge test piloted in Phase I, scores on the Roter Interaction Analysis System (RIAS) used for coding audio recorded interactions in the Virtual Patient Assessment, a Liking Scale, and user evaluations of the course. The completed course will be marketed to healthcare organizations and professional associations as well as schools of medicine and residency training programs as a resource in the national campaign to eliminate healthcare disparities. 7. PUBLIC HEALTH RELEVANCE: Following the Institute of Medicine's landmark report Unequal Treatment, the evidence base on the nature and causes of healthcare disparities continues to grow, policy statements and program guidelines are published, and yet a large number of physicians remain disturbingly unaware of the disparities in their field of practice. The goal of the Healthcare Disparities: Patients &Providers e-learning course is to eliminate disparities that may be due to patient-provider interactions by improving knowledge about disparities, promoting reflection on providers'unconscious bias, and enhancing skills for communication and relationship building with racial/ethnic minority patients. The course will be one resource in the multilevel campaign to eliminate racial/ethnic disparities in healthcare by 2010.